For a segment of society, there has been something more troubling than the specter of running low on toilet paper during lockdown. As the days stretched to weeks and then to months, many began quietly wondering: What will happen to my face without Botox? And is it worth breaching social distancing protocol in order to never find out?
There have been whisperings about one percenters wooing Manhattan dermatologists out to their Hamptons havens equipped with stealthy syringes of neurotoxin, and a keen eye can detect suspiciously chemical-peel-fresh-skin on the social media dispatches from the Upper East Side. Yet, while work is being done, no one is naming names.
“I’ve had a few requests, though I hope most of them were joking,” says dermatologist Robert Anolik, MD, of New York’s Laser & Skin Surgery Center. “I’m happy to say that no one I know personally has breached New York State’s PAUSE [executive order] on non-essential work, but I have heard rumblings that there are people out there who have been pressured, and who have caved.”
The ethics of administering a little injectable boost during a pandemic are more than a little dubious, Anolik says. “Whenever I hear about people giving a treatment—which is a medical procedure—in someone’s bathroom at home, it makes me question the overall quality and safety of that person’s practice in general. And that’s compounded with the fact that it’s now breaking the law.”
The majority of those making house calls, Anolik suspects, are not the top-tier board-certified dermatologists one would seek out for best results in non-pandemic times. “Unfortunately, there are will always be someone offering cheaper, less-safe alternatives to real medical facilities with real dermatologists. It’s not a good idea, but if you really wanted to you could probably get Botox in a corner shop next to a 7-11. Those kinds of places might have people who are more open to doing things like breaking Governor Cuomo’s rules because their standards are already low.”
In Los Angeles, where expectations of upholding a certain level of perceived agelessness can be an occupational imperative, the pressure on dermatologists to make special exceptions has been particularly intense.
“I think there are more people than are willing to admit who have made house calls, or have been doing it. I know clinics that never stopped,” says Redondo Beach-based dermatologist Annie Chiu, MD. “I did get a lot of calls, especially in the beginning, from patients basically asking me if I could meet them in the back alley.”
She resisted, but admits feeling anxious about it, in part because she didn’t want to disappoint patients, including a newscaster whose job necessitated being on camera every day. “It was a difficult position to be in. I was like, ‘I understand it's actually part of your job and you are essential right now,’ but Botox isn’t," she said. Chiu has made one exception, she says, for a patient who had to come in for a biopsy following a video consultation. “She asked if I could do her Botox, too, and I thought, 'Well, she is already here.' And she had a totally legitimate reason for being in the office.”
In Beverly Hills, where restrictions on elective surgeries were lifted last week, cosmetic surgeons are back in action, despite a degree of consternation from their peers outside the region. “It’s murky, because the guidelines everywhere are different,” says Chiu, who is planning to open her practice with strict safety protocols in place by May 18. “It's a subject nobody quite wants to talk about. There's demand for it, and we all want to get back to work, but we all realize that Botox is not essential during a pandemic.”
Now that restrictions are closer to being lifted in some places, it’s easier for dermatologists to tell patients to sit tight.
“I don’t feel like the horizon is so far off at this point where we’re going to be able to do injectables safely and ethically in the office,” says Anolik, who is currently scheduling appointments beginning June 1.
For those who are still panicking that their looks will be lost in the meantime, he reassures them thus: “We’re not talking about delaying treatments for a year," he adds. "As long as people keep up with good skincare at home, and use their moisturizer and sunscreen, they’ll be ok. We can pick things back up again when we finally get back in the office.”